A Recap of the 2021 Texas Legislative Session and HIV

The regular session of the 87th Texas Legislature began on January 12 and concluded on May 31, 2021. Advocacy is one of the guiding principles of the Achieving Together Plan. Through advocacy, we aim to promote and implement policies that support the work in all areas of the plan. We need supportive policies at the federal, state, local, and organizational levels. Achieving Together sat down with Januari Fox, Director of Policy and Advocacy for Prism Health North Texas, to learn more about the HIV-related items addressed during the session and their potential impact on HIV prevention, treatment, and care in Texas.

What were the main legislative priorities around HIV as this session started?

Going into the session, we had House Bill 369, which would have increased the criminal penalties for aggravated assault by communicable disease, on our radar. This is a typical HIV criminalization bill, even though HIV is not directly named. However, we quickly learned that the budget for the Texas HIV Medication Program was in a critical state. An immediate $52 million in funding was needed to keep the program solvent through August 2021, with an additional $104 million needed for the 2022-23 budget cycle.  The $52 million was found through Coronavirus Relief funds and federal supplemental funding, which was excellent. The work lay with the $36.6 million being requested through an exceptional item in the state budget.

What did you and your fellow advocates do during the session to help push increased funding for the HIV program and how receptive were legislators?

Advocates started visiting with our legislative champions very early on, educating them on the need for the THMP program to remain fully funded. We met with Representatives Toni Rose, Julie Johnson, and Donna Howard, and collected letters of support from Representative Garnet Coleman and Senator Boris Miles. We met with the Speaker of the House’s office, as well as the office of the Governor. Legislative briefs were created and distributed, and we had a great deal of contact with the media, who showed a particular interest in this story. Senator Louis Kolkhorst was one of our strongest champions, rallying for us during the appropriations process.

 What was the outcome and what is your response to the outcome?

I am thrilled to say that the program was awarded $36.6 million in state budget funds through strong community advocacy and watchfulness. However, this is far less than the $104 million needed to keep the program solvent over the next two years. The state HIV/STD department is taking a considerable risk at the expense of people living with HIV. They are counting on federal supplemental funding and Coronavirus Relief funding, which will be determined later. If these funds are not received, by DSHS’s calculations up to 5,800 people living with HIV would be relegated to a waitlist and unable to receive their medications.

 How will the outcome change or not change the work you do?

Our next steps are to ensure the THMP receives the approximately $15 million needed to keep Texans off wait lists in the very near future. This will more than likely happen during one of the upcoming special sessions being called by the Governor. Moving forward, advocates want to focus on the growth of the program, including increasing FPL eligibility, adding more medications to the formulary, and addressing systemic barriers that make it difficult for both people living with HIV and the organizations who serve them to be as effective as possible.

What are ways that others can get involved in the future?

One of the easiest ways for people to get involved and stay up to date is to JOIN the Texas Strike Force. This amazing group of advocates stay on top of all information the community needs to be aware of and organizes accordingly. I also want to encourage people to attend the quarterly Texas HIV Medication Program Advisory Committee meetings. These open meetings are a great way to hear about what is going on at the state level, and attendees are allowed up to three minutes of public comment. DSHS is also making a concerted effort to be more transparent and communicative with stakeholders and have held several town halls and partnership meetings. It is important for us to remain involved and at the table as much as possible.


Januari Fox, Director of Policy and Advocacy for Prism Health North Texas

Empowering & Assisting Homeless LGBTQ+ Youth in Texas

April 10 is National Youth HIV/AIDS Awareness Day. This is a day to educate the public about the impact of HIV and AIDS on young people. The day also highlights the HIV prevention, treatment, and care campaigns of young people in the U.S.

Here in Texas, several organizations work to support a particularly vulnerable population: homeless LBGTQ youth. One of these organizations is Thrive Youth Center, Inc. in San Antonio. Thrive was established as a 501(c)(3) in February of 2015, and their mission is to “provide a safe, effective, and supportive center for homeless LGBTQ youth, so they may become productive, skilled, educated, and successful adults with the ability, opportunity, and possibility of achieving their dreams.” Thrive’s emergency shelter, which is located on Haven for Hope’s campus, opened in 2015, and currently there are 10 beds for LGBTQ young adults ages 18-24. In addition to clients onsite in the shelter, Thrive received a federal grant in 2017 that allowed them to house 20 young adults in their own apartments with rental assistance for up to one year. Through its street outreach program, Thrive strives to get young adults off the streets and into shelter, either at Thrive or through another program.

Services provided by Thrive include:

  • Case management
  • Education services
  • Empowerment resources
  • Mental health services
  • Life skills
  • Medical care
  • Legal services
  • Aftercare support for residents after leaving Thrive

Thrive is one of only a handful LGBTQ-specific programs serving homeless youth in Texas. Others include the Dune LGBT Foundation in Dallas. Dune’s programs offer emergency housing resources, rapid rehousing programs, housing programs offer an expected stay of up to 6 months. Tony’s Place in Houston also works to empower homeless LGBTQ+ youth and helps them “survive on a day-to-day basis by providing services to meet their immediate, basic needs.”

While not a shelter, Out Youth, based in Austin, provides much needed services and care to LGBTQ youth. Out Youth has compiled several resources guides, which can be found here

REPRODUCTIVE JUSTICE: A CONVERSATION WITH MARSHA JONES

The CDC reports that African American and other Black women continue to be disproportionately affected by HIV. In addition, Black people living with HIV continue to face inequalities in HIV care.

The Black Women’s Affinity Group, in collaboration with Achieving Together, is comprised of community members working to address disproportionate transmission rates, addressing health disparities for Black women, and increasing access to care. The focus of the Black Women’s Affinity Group is to address gaps in connecting with clients, providers, and community through culturally responsive and affirming messaging, provide culturally affirming and empowering self-care, and to ensure Black women are included as decision-makers in regard to prevention and care programming from a planning, financing, and implementation standpoint.  

The Black Women’s Affinity group is excited to have Marsha Jones, Executive Director and Co-Founder of The Afiya Center, as the group’s inaugural speaker for Achieving Together.  Marsha is a nationally known women-focused supporter of gender and racial equity who works to eliminate health disparities for Black women.  On November 16, 2020, at 11:00am Central, Marsha will be speaking on Reproductive Justice and the Intersection of HIV. 

Will you join us? Please register for the webinar here.

Champion for Change

The month of September 15 to October 15 is National Hispanic Heritage Month in the United States. Organizers chose this time period because it reflects the independence days for many Latin American countries, including Mexico’s famous Grito de Dolores on September 16. First recognized by President Lyndon B. Johnson in 1968 as a week of recognition, President Ronald Reagan expanded it to a month in 1988. People of Hispanic or Latinx heritage represented approximately 38% of Texas’ population in the 2010 census, but that population is “expected to become the largest population group in Texas as soon as 2022.” 

Achieving Together’s Guiding Principles

Despite representing some of the oldest Texas’ residents, the Latinx population in Texas faces many barriers to equity, including access to affordable housing, healthcare, and education. Not only do the guiding principles of the Achieving Together Plan implore us to action in addressing these issues, the plan lays out a guide for addressing many of these barriers in order to successfully end the HIV epidemic in Texas. The plan stipulates that “addressing mental health, substance use disorders, criminal justice, and housing is essential to creating supportive and stable environments in which people can achieve their health and wellness goals.” In addition, the plan recognizes that “Community-guided planning and data that is inclusive of all population groups will support programs and interventions that are culturally appropriate and will help people find the right pathway to meet their health and wellness goals.” Only by recognizing our history and working together to create a shared vision of the future can we successfully end the HIV epidemic in Texas. Join us!

In honor of Hispanic Heritage Month, Texas HIV Syndicate member Elias Diaz, from Eagle Pass, penned the following essay on his reflections as a community organizer and health advocate for his community.


Champion for Change
By Elias Diaz

I’m a mental health care provider, a public health advocate, and a community organizer. Going into politics wasn’t in the plan. Truth be told… I hate politics. I don’t identify as a politician. I’m not sure I ever will. 

Even after a victory, I raise up my head with pride, but can’t help but to feel the effects this battle had on my body. There were a million reasons not to do this, but I’ve never been one to back down from a fight. 

My fight is long and sordid. It’s never been for a political position, but rather to reclaim the power for my people.  It’s tears and it’s bloodshed. It’s swords and it’s stones. It’s conquest and colonization. It’s passion incarnate. 

My fight is like my language. The Nahuatl words hidden in my Spanish. The Spanish clinging to my English sentences. My English decorated with my accent. It’s the sound I’ve given to the little brown boy that lives inside me… the one that learned silence as his primary language in order to survive. It’s the same language that the voiceless child speaks inside the detention centers. It’s the silent song of the early martyrs of the HIV pandemic.

My fight is the unruliness in my hair. It’s rebellion against systems of oppression. The ones that limit opportunities for housing, promote mass incarcerations, and prevent our people from healing. 

My fight is like the pigment in my skin demanding visibility. Visibility for the most marginalized populations. It’s the need of the LGBQ youth to be seen by their families and their communities.  It’s power in presence; a changed gender marker. It’s resilience personified.

My fight is calloused hands and feet. It’s the long journey that my grandparents took to get to this journey. It’s crossing deserts, walking through canyons, and climbing sierras. It’s mental illness and it’s substance abuse. It’s wondering where to go next, wanting to stop, and knowing you have to keep moving. 

My fight is like the strength in my back. The same strength that powers the worker in the fields. It carries the burden of income inequality, lack of access to healthcare, and inequities in education. It is the resilience of the cactus that causes it to thrive in the harshest of environments. 

My fight is the fullness in my lips. They swell and burst with truth. It’s my unapologetic sexuality. It’s the dignity of the sex worker. The vibrant color of the desert flower.  

My fight is like my food. It’s spicy. It’s poignant. It’s full of boldness and flavor. It’s unrepentant. It demands preparation by looking at our past. It fosters collaboration across systems. It promises a seat the table for all. 

My fight is my religion. It is the sacred dance of my ancestors. It is irreverence in the face of fear. My fight is the confession of classism, colorism, and machismo. My fight is resurrection and evolvement time and time again. My fight is building sanctuary across our systems of care. 

My fight is my tradition. It has deep memories of rape and pillage, stolen land, and forced assimilation. It is hope and it is freedom.  

My fight is the greatest of revolutions. It is recognizing and honoring the fight in you. It is empowerment and it is truth. My fight is a battle cry for a heartbroken community. My fight is a call to action to those that have been broken by these systems to rise up and dismantle them. My fight is a charge against our way of doing things. My fight is a plea for you to rise up and be the champion for change that we have continuously prayed for. 


Elias Diaz made history in Eagle Pass after becoming the first openly LGBTQ candidate to get elected to public office in his area. His hard-fought election came after an eight-month long campaign that included a runoff election, postponement of the election due to the COVID-19 pandemic, and multiple personal attacks. Although Eagle Pass is registered as a blue city, the region is home to many residents whom Diaz says identify with “traditional conservative values.”

Diaz has been a longtime champion of marginalized communities. He has overcome a multitude of barriers including economic disadvantage, childhood domestic violence, and sexual abuse, and used his experiences to fight for social justice and equality for others. Diaz put himself through college in LA by starring in adult films. Pictures and videos of his sex work circulated on the internet during his campaign and were used against him in an attempt to demoralize him and question his ability to lead. Diaz remained transparent about his past and used the attacks to connect to inspire voters in his community to rise up against injustice and inequality. In the end, he beat his opponent by 517 votes, according to Eagle Pass Business Journal.

You’re An Activist, Too!

By Ian Haddock, Houston

Wow! Over a year ago, I had the privilege of submitting a piece to Achieving Together about our project, “Outcry the Docu-Series”. It is now streaming on Amazon’s Prime Video along with the mini-documentary and we are thrilled. Even with all of that, I never expected The Normal Anomaly Initiative to be in the place in which we are today.

It took me a long time to figure out how the work that I was passionate about fit into this work in public health, specifically ending the HIV epidemic. Many of my colleagues were leading the movement as researchers on innovative ways to take PrEP, working for national philanthropic organizations, creating behavioral interventions and working for pharmaceutical companies. I, myself, just wanted to create programming and tell people’s stories. Without any clear plan at the beginning, over the last 5 years, that’s what we’ve done.

Since then, people have begun calling me an activist; I never considered myself an activist. Approximately 8 years ago, I was at the most difficult time of my life following my mother’s passing. I found myself in group counseling for grief followed by seeing a therapist since then. I found that my vulnerability and story was important to create the world that I desired for myself.  Through initiating this healing with myself and following my own path of passion and purpose, I ended up just being a part of a reflection of what healing is in our community. The people who have joined us on this journey have triumphed through their process of healing and now we create programs and curriculum to facilitate other’s journeys for the communities we intersect. It is still a wonder that I am around such visionaries and power.

In August 2019, The Normal Anomaly Initiative was accepted into our first shared learning experience with the Gilead Compass Initiative with a 4-month course in Healing Justice while also being in a cohort for cultivating our organizational infrastructure. This created a space for us to really decide how to not just create projects but pay special attention to what we had to offer to end the HIV epidemic. Since then, we have been taking leadership development training, harm reduction training, enrolled one of our members in Project LEAP, and focused on developing curricula such as cultural humility trainings for faith-based organizations and marketing and branding trainings for emerging Black queer leaders in the South to meet the needs of the communities we are a part of.

Additionally, we have begun to bring some innovative methods that we created based on evidence-based work from advocates across the state. For example, years ago we worked with one of the fearless leaders of Positive Women’s Network, Ms. Venita Ray, on some cultural humility trainings for providers and have now transformed that training into cultural humility trainings for faith-based organizations called “Outcry the Community Project.” We also mixed our healing justice and harm reduction lens and helped to create the Transgender Ally Collective in Houston; this collective is committed to actionable items that will work to protect the lives of transgender people with a current focus on Black transwomen.

With the help of funding sources that are open to our grassroots methods, we are able to make impact that moved from hundreds of thousands of impressions on digital media to hundreds of thousands of in-person impressions in our city over the next few weeks with our billboard in Houston’s 5th Ward.

I love talking about the journey of our grassroots organization, but not just out of pride; it is with the intent to reach each and every community member that desires to do the work to end the HIV epidemic. Many times, we have such a strict focus on those in public health that we miss the people who are doing their part in this work in the community at-large; this work is evident even in the most non-specific spaces. Over the years working in this field, I have found myself working with club owners and promoters and never really understanding the impact that those relationships have on lowering the risk of transmission of HIV; however, these gatekeepers are integral parts of the movement to end the epidemic. For marginalized communities, we have historically had spaces in which we went to escape from the world; for Black people, for instance, it has been the church. For Black queer people, many times, it is the club or a bar. This place of escape translates to one of the places that community shows up both the most vulnerable and the most wholly themselves. For this reason, they are a necessary aspect of outreach, mobilization and community. I also come from a community of sex workers where our conversations helped us figure out how to negotiate sexual encounters even before we knew the proper terminology. Titan Capri, one of the leaders of our programs, teaches people how to talk through their issues through a podcast; additionally, Kimberly Thomas, one of our other leaders, does the work through styling where she builds self-esteem and confidence. Many of our transwomen do the work by simply choosing to step over the threshold of their door every morning into a society that often doesn’t understand their lives and experiences.

From sending people to the Capitol to advocate for better policies to work on OnlyFans advocating sex positivity and accepting responsibility for their own bodies with PrEP, we salute the work that must be done in all spheres to make statements. Long before we had any idea on how to go about erecting a billboard, we were using our small DSLR camera to create impact; we didn’t recognize it then, but we were a part of changing the narrative of what this work looks like. The answer to ending the HIV epidemic will be found at the grassroots level when we recognize that everyone—no matter what they bring to the table—is and can be a part of ending this epidemic; this means you’re an activist, too—even if no one has ever told you and you’ve never worked in public health.